阿帕替尼治療12例晚期肺癌的近期療效評價

李超群　王秀明　朱凌燕

[摘要] 目的 評價阿帕替尼治療晚期肺癌的近期臨床效果。 方法 回顧性分析2017年6月～2018年10月蕪湖市第二人民醫院收治的12例晚期肺癌并采用阿帕替尼治療患者的臨床資料，每4周為1周期，評價臨床療效，記錄不良反應并指導防治，連續評價3周期。 結果 1周期后疾病控制率為91.67%，2周期時疾病控制率為63.64%，3周期時疾病控制率為42.86%，不良反應中以蛋白尿和痰中帶血最常見，以痰中帶血最嚴重。 結論 阿帕替尼治療晚期肺癌近期效果顯著，隨著治療時間延長，效果呈下降趨勢。不良反應一般可耐受，值得臨床推廣。

[關鍵詞] 阿帕替尼;晚期肺癌;抗血管生成;臨床療效;不良反應

[中圖分類號] R737.9? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-7210（2019）06（b）-0137-04

Evaluation of short-term efficacy of Apatinib in the treatment of 12 patients with advanced lung cancer

LI Chaoqun? ?WANG Xiuming? ?ZHU Lingyan

Department of Oncology， the Second People′s Hospital of Wuhu， Anhui Province， Wuhu? ?241000， China

[Abstract] Objective To evaluate the clinical efficacy of Apatinib in the treatment of advanced lung cancer. Methods The clinical data of 12 patients with advanced lung cancer treated with Apatinib from June 2017 to October 2018 in Second People′s Hospital of Wuhu were retrospectively analyzed， 4 weeks for one cycle. The clinical efficacy was evaluated， adverse reactions were recorded， prevention and treatment were guided， and 3 consecutive cycles were evaluated. Results The disease control rate was 91.67% after one cycle， 63.64% at two cycles and 42.86% at three cycles. Proteinuria and blood in sputum were the most common adverse reactions， and blood in sputum was the most serious. Conclusion The short-term efficacy of Apatinib in the treatment of advanced lung cancer is remarkable. With the prolongation of treatment time， the efficacy shows a downward trend. Adverse reactions are generally tolerable and worthy of clinical promotion.

[Key words] Apatinib; Advanced lung cancer; Anti-angiogenesis; Clinical efficacy; Adverse reactions

近年來，肺癌的發病率和死亡率在我國迅速攀升，嚴重威脅著人民健康。隨著影像學檢查和生物標志物檢查的推廣，早期肺癌發現較前增多[1-3]，但仍有超過70%的肺癌患者首次發現時已進入晚期而失去手術機會[4]，其5年生存率僅為4%～17%[5]。目前晚期肺癌主要以內科治療為主，包括化療、放療、分子靶向治療和免疫治療等多種綜合治療。然而，常規的化療和放療對晚期肺癌療效并不顯著，且患者耐受性差，免疫治療因價格昂貴限制其在臨床普及[6]。分子靶向治療因其療效確切，價格適中已經在臨床治療實踐中得到普遍推廣。2014年由江蘇恒瑞醫藥股份有限公司生產的小分子抗血管生成新藥阿帕替尼（Apatinib）批準上市（國藥準字H20140103，規格：0.25 g），作為我國首個自主研發的分子靶向藥物主要用于一、二線治療失敗的晚期胃癌和胃食管結合部腺癌，其治療效果令人鼓舞[7]。……